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Conditions - MSK > Gout > Flashcards

Gout Flashcards

1
Q

What is gout?

A

A form of arthritis caused by excess uric acid in bloodstream. Known as “Henry VII Disease”

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2
Q

What causes the symptoms of gout?

A

Formation of uric acid crystals in joints.

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3
Q

What is the specific type of uric acid crystals found in patients with gout?

A

Monosodium Urate

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4
Q

Where is the most common place to find gout?

A

Base of the big toe. Gravity init

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5
Q

What demographic is more likely to have gout?

A

Old Men

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6
Q

What is the main risk factor for gout?

A

Excessive red meat consumption. Paired with reduced fruit consumption.

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7
Q

How does gout present? (2)

A
  1. Sudden sever pain in any joint (usually the big toe).
  2. Inflamed skin over affected joint
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8
Q

What is the percentage of patients that present with big toe gout?

A

70% of gout cases are in the first metatarsophalangeal joint (MTPJ)

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9
Q

What is the method to diagnose Gout?

A

History

Examination

Ruling out differential diagnosis.

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10
Q

What is the only investigation that can confirm gout?

A

Arthocentesis (with synovial fluid analysis)

This helps differentiate from pseudogout.

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11
Q

What investigation can we undertake to diagnose gout, other than arthrocentesis? (1)

A

X-Ray:

Joint effusion is an early sign.

You can see well-defined “punched out” erosion.

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12
Q

What do we see in a microscope of a gout arthrocentesis sample?

A

Needle-shaped crystals.

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13
Q

What lifestyle changes do we recommend to patients of gout? (2)

A

Reduction of red meat and alcohol consumption.

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14
Q

How do we treat acute flare-ups of gout? (3)

A
  • NSAIDs
  • Colchicine
  • Steroids (IA, IM or Oral)
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15
Q

What medications are used to treat hyperuricaemia associated with gout? (4)

A
  1. Xanthine Oxidase Inhibitor (i.e. Allopurinol)
  2. Febuxostat
  3. Uricosuric agents (sulphinpyrazone, probenecid, benzbromarone)
  4. Canakinumab
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16
Q

What are the main rules of treating gout? (4)

A

1) Don’t treat the first flare up (unless it’s they have renal insufficiency, clearly a single attack of polyarticular gout or tophaceous gout / presence of urate calculi)
2) Treat it if it’s the second attack in a year.
3) Treat prophylactically prior to treating certain malignancies.
4) DO NOT TREAT if asymptomatic.

Conditions - MSK (37 decks)

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